Mortality and independent risk factors in pediatric Stenotrophomonas maltophilia bacteremia: a retrospective cohort study

Abstract Purpose Stenotrophomonas maltophilia is an intrinsically multidrug-resistant Gram-negative bacillus increasingly implicated in nosocomial bloodstream infections. Mortality rates in pediatric populations remain high, yet data on independent predictors of adverse outcomes are limited. We aimed to evaluate clinical characteristics, antimicrobial susceptibility patterns, and risk factors associated with mortality in pediatric patients with S. maltophilia bacteremia. Methods We conducted a retrospective cohort study including hospitalized children (0–18 years) with blood cultures positive for S. maltophilia . Demographic and clinical data were extracted from medical records. Risk factors for mortality were assessed using univariate and multivariate logistic regression analyses. Results Seventy-three patients were included (67.1% male), with a median age of 1.96 years. Underlying conditions included hematologic malignancy (22%), solid tumors (17.8%), and neurologic disorders (16%). Intensive care unit (ICU) admission was required in 67.1% of cases. Crude mortality was 41.1%, and attributable mortality was 23.2%. In multivariate analysis, ICU admission, mechanical ventilation, and corticosteroid use were independently associated with mortality. Conclusions Pediatric S. maltophilia bacteremia is associated with substantial mortality. Adverse outcomes appear to be primarily driven by severity of illness and immunosuppressive factors. Early recognition of high-risk patients requiring intensive care support may improve clinical management and outcomes.